Parental-notification law appears to limit, delay abortions

(Reuters Health) - Minors had nearly one-third fewer abortions in an Illinois clinic in the year after the state enacted a parental-notification law, according to new research questioning the legislation’s utility.

Proponents claim parental-notification laws lead to increased family communication and parental support, but the study suggests that the law failed on that score and might have erected barriers to care.

Minors traveling from out of state to have abortions in Illinois were more likely to have second-trimester than first-trimester abortions after the law took effect, the Journal of Adolescent Health report found.

“These laws are not improving the circumstances in which minors make decisions around abortion, and they may be putting the health and well-being of minors at risk by delaying access to care,” said lead author Lauren Ralph, an epidemiologist at Advancing New Standards in Reproductive Health, a research group at the University of California, San Francisco.

“If you are preventing minors from obtaining the care they want, that should be concerning,” she said in a phone interview.

Dr. Maria I. Rodriguez, a professor of obstetrics and gynecology at Oregon Health & Science University in Portland who was not involved with the study, said it “demonstrates the harms associated with a very common policy, which 38 states have implemented, ostensibly to protect women.”

Two-thirds of the states with parental-involvement laws require parental consent, although Illinois requires only notification, Ralph said.

When Illinois implemented the law in August 2013, girls under the age of 18 had to travel as far as New York or New Mexico to find a clinic where they could have an abortion without first notifying a parent.

Ralph and her team analyzed records from one private abortion clinic in southern Illinois to examine the impact of the parental-notification requirement on minor girls.

In the year following enactment, the clinic performed 29 percent fewer abortions on girls under the age of 18 but only 2 percent fewer abortions on young women from 18 to 20 years old, the study found.

Before the law, 71 percent of parents knew about their children’s pregnancies, while after the law’s implementation, 93 percent knew about the pregnancies. At the same time, parental supportiveness (as reported by the minors) remained the same, as did minors’ confidence in the certainty of their decision.

Minors from neighboring states with stricter abortion laws continued to travel to Illinois for abortion care following enactment of the parental-notification law, the study found. But, after the legislation was enacted, minors from outside the state were more likely to have later abortions.

Underage girls who traveled to Illinois from other states to have abortions were 47 percent more likely to have the procedure in their second trimester than in their first trimester, the study found.

Abortions are safest when performed earlier, Rodriguez said in an email.

“We are currently seeing a flood of different types of legislation that enact barriers to safe abortion care,” she said. “The study shows that increasing parental awareness does not improve the support adolescents receive, and it is associated with a delay in care, putting them at risk for adverse health outcomes.”

Rodriguez believes that restricting access to abortion increases poor health outcomes for women. “As an Ob-gyn,” she said, “this makes me worried for the health and wellbeing of American women.”